stool, or if the individual shows signs of dehydration.
Infants and children need prompt medical care if they
appear to be dehydrated, disoriented, lethargic, have a
fever over 102F (39C), or have uncontrolled vomit-
ing and diarrhea.
Nutrition/Dietetic concerns
The greatest health risk accompanying traveler’s
diarrhea is dehydration. This is a potentially serious
problem in infants and small children who can become
dehydrated from vomiting and diarrhea within hours.
A main goal of treatment is to keep the individual from
becoming dehydrated. Infants, children, the elderly,
and others who are losing large amounts of fluid from
diarrhea should be given an oral rehydration solution.
Oral rehydration solutions have the proper balance of
salts and sugars to restore fluid and electrolyte balance.
In industrialized countries, already-mixed oral rehydra-
tion solutions are available in cans or bottles at super-
markets and pharmacies. In the rest of the world, dry
packets of WHO oral rehydration salts are available.
The contents of the packet are mixed with 1 L of clean
(i.e. boiled or purified) water. This solution can be given
to young children in small sips as soon as vomiting and
diarrhea start. Children may continue to vomit and
have diarrhea, but some of the fluid will be absorbed.
In the past, parents were told to withhold solid food
from children who had diarrhea. New research indi-
cates that it is better for children should to be allowed to
eat solid food should they want it, even though diarrhea
continues.
Older children and adults can stay hydrated by
drinking liquids that they know are uncontaminated,
such as bottled water, bottled fruit juice, caffeine-free
soft drinks, hot tea, or hot broth. Normally 2–3 quarts
(2–3 L) should be drunk in the first 24 hours after
diarrhea starts, moving to solid food as symptoms
improve.
Prognosis
Although traveler’s diarrhea can make anyone
feel miserable, most people recover from the disease
within 3 to 5 days with nothing worse than disrupted
travel plans. About 20% of travelers are sick enough
to stay in bed for at least one day, and in about 10% of
people the symptoms last more than a week. People
with compromised immune systems, kidney disease, or
who are very young or elderly may be sicker longer
than other individuals. People who develop diarrhea a
few days after returning home from an area where
traveler’s diarrhea is common should take into con-
sideration that they may have brought a parasitic
infection home with them.
Prevention
It is difficult to prevent all traveler’s diarrhea,
although with care, the chances of getting sick can be
reduced. Some common sense preventative measures
include the following:
Avoid tap and well water including ice cubes in
drinks.
Avoid raw peeled fruits and raw vegetables.
avoid unpasteurized milk, dairy products (e.g. ice
cream, yogurt) and unpasteurized fruit juices.
Do not buy food from street vendors.
Wash hands often in uncontaminated water.
Choose hot drinks such as coffee or tea or canned or
bottled drinks
Resources
BOOKS
Parker, James N.The Official Patient’s Sourcebook on
Travelers’ Diarrhea. San Diego: CA Icon Health Pub-
lications, 2002.
PERIODICALS
Steffen, Robert, Francesco Castelli, Hans Dieter, et al.;
‘‘Vaccination Against Enterotoxigenic Escherichia
Coli, A Cause of Travelers’ Diarrhea.’’Journal of Travel
Medicine.12, no.2 (2005):102-107.
Yates, Johnnie. ‘‘Traveler’s Diarrhea.’’American Family
Physician. 71, no.11 (June 1. 2005): 2095ff.<http://
http://www.aafp.org/afp/20050601/2095.html>
ORGANIZATIONS
United States Centers for Disease Control and Prevention
(CDC). 1600 Clifton Road, Atlanta, GA 30333. Tele-
phone: (800) 311-3435 or (404) 639-3534. Website:
lt;http://www.cdc.gov>
OTHER
Buscaglia, Anthony L. and Ronald M. Moscati. ‘‘Traveler’s
Diarrhea.’’ eMedicineHealth.com, August 10, 2005
2005.<http://www.emedicinehealth.com/travelers_
diarrhea/article_em.htm>
Centers for Disease Control and Prevention ‘‘Traveler’s
Diarrhea.’’ November 21, 2006.<http://www.cdc.gov/
ncidod/dbmd/diseaseinfo/travelersdiarrhea_g.htm>
Centers for Disease Control and Prevention, ‘‘Risks from
Food and Water.’’ InTraveler’s Health: Yellow Book.
Chapter 2: Pre- and Post- Travel General Information,;
2005–2006 edition.<http://www2.ncid.cdc.gov/>
Centers for Disease Control and Prevention, ‘‘Travelers’
Diarrhea.’’ InTraveler’s Health: Yellow Book. Chapter
4: Prevention of Specific Infectious Diseases, 2005–2006
edition.<http://www2.ncid.cdc.gov/>
Traveler’s diarrhea